# Elevated circulating dipeptidyl peptidase 3 (cDPP3) as a predictor of postoperative complications in esophagectomy patients

## TL;DR

This study shows that elevated levels of a protein called cDPP3 can predict complications after esophagectomy surgery for cancer.

## Contribution

The study introduces cDPP3 as a novel biomarker for predicting postoperative complications in esophagectomy patients.

## Key findings

- Elevated cDPP3 levels correlated with increased SOFA scores and severe complications like pneumonia and sepsis.
- cDPP3 levels at 72 hours were significantly linked to anastomotic insufficiency.
- A negative correlation was found between intraoperative volume and cDPP3 levels at 24 hours.

## Abstract

Esophagectomy for esophageal cancer carries high postoperative morbidity and mortality. Circulating dipeptidyl peptidase 3 (cDPP3) is a novel biomarker linked to organ failure in acute care. This study evaluates its prognostic value for predicting organ dysfunction and mortality post-esophagectomy.

This prospective, single-center study included 20 esophagectomy patients. cDPP3 levels were measured preoperatively and at 24, 72, 120, and 168 h postoperatively using a Nexus IB10 Analyzer. Postoperative complications, including pneumonia, anastomotic insufficiency, and SOFA score-based organ dysfunction, were recorded. Correlation analysis assessed associations between cDPP3 levels and clinical outcomes.

Among 20 patients, the most common complications were pneumonia (n = 12), sepsis (n = 17), and anastomotic insufficiency (n = 5). Elevated cDPP3 levels correlated with SOFA score increases ≥ 2 (p < 0.01) and severe complications, including prolonged ICU stays. cDPP3 levels at 72 h were significantly associated with anastomotic insufficiency (p < 0.01). A negative correlation was observed between intraoperative volume and cDPP3 levels at 24 h (r = -0.495, p = 0.03).

cDPP3 is a potential biomarker for postoperative complications after esophagectomy. Its elevation correlates with increased morbidity, highlighting the need for vigilant perioperative management.

The online version contains supplementary material available at 10.1007/s00423-025-03893-4.